Gentamicin loading of calcium phosphate implants: implications for cranioplasty.
Calcium phosphate
Gentamicin
PEEK
Staphylococcus
Titanium
Uptake-release
Journal
Acta neurochirurgica
ISSN: 0942-0940
Titre abrégé: Acta Neurochir (Wien)
Pays: Austria
ID NLM: 0151000
Informations de publication
Date de publication:
06 2019
06 2019
Historique:
received:
19
11
2018
accepted:
25
03
2019
pubmed:
2
5
2019
medline:
14
4
2020
entrez:
2
5
2019
Statut:
ppublish
Résumé
Surgical site infections (SSI) are a significant risk in cranioplasty, with reported rates of around 8-9%. The most common bacteria associated with these nosocomial infections are of the Staphylococcus species, which have the ability to form biofilm. The possibility to deliver antibiotics, such as gentamicin, locally rather than systemically could potentially lower the early postoperative SSI. Various antibiotic dosages are being applied clinically, without any true consensus on the effectiveness. Drug release from calcium phosphate (CaP), polyetheretherketone (PEEK), and titanium (Ti) samples was evaluated. Microbiological studies with Staphylococcus aureus (SA) and Staphylococcus epidermidis (SE) including strains from clinical infection were used to establish clinically relevant concentrations. The CaP samples were able to retain and release gentamicin overtime, whereas the Ti and PEEK samples did not show any drug uptake or release. A gentamicin loading concentration of 400 μg/ml was shown to be effective in in vitro microbiological studies with both SA and SE. Out of the three materials studied, only CaP could be loaded with gentamicin. An initial loading concentration of 400 μg/ml appears to establish an effective gentamicin concentration, possibly translating into a clinical benefit in cranioplasty.
Sections du résumé
BACKGROUND
Surgical site infections (SSI) are a significant risk in cranioplasty, with reported rates of around 8-9%. The most common bacteria associated with these nosocomial infections are of the Staphylococcus species, which have the ability to form biofilm. The possibility to deliver antibiotics, such as gentamicin, locally rather than systemically could potentially lower the early postoperative SSI. Various antibiotic dosages are being applied clinically, without any true consensus on the effectiveness.
METHODS
Drug release from calcium phosphate (CaP), polyetheretherketone (PEEK), and titanium (Ti) samples was evaluated. Microbiological studies with Staphylococcus aureus (SA) and Staphylococcus epidermidis (SE) including strains from clinical infection were used to establish clinically relevant concentrations.
RESULTS
The CaP samples were able to retain and release gentamicin overtime, whereas the Ti and PEEK samples did not show any drug uptake or release. A gentamicin loading concentration of 400 μg/ml was shown to be effective in in vitro microbiological studies with both SA and SE.
CONCLUSIONS
Out of the three materials studied, only CaP could be loaded with gentamicin. An initial loading concentration of 400 μg/ml appears to establish an effective gentamicin concentration, possibly translating into a clinical benefit in cranioplasty.
Identifiants
pubmed: 31041594
doi: 10.1007/s00701-019-03895-4
pii: 10.1007/s00701-019-03895-4
pmc: PMC6525671
doi:
Substances chimiques
Anti-Bacterial Agents
0
Bone Cements
0
Calcium Phosphates
0
Gentamicins
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1255-1259Références
Acta Orthop Traumatol Turc. 2018 Jul;52(4):289-293
pubmed: 29887199
Curr Orthop Pract. 2011 Nov;22(6):558-563
pubmed: 22323927
Front Microbiol. 2017 Jun 08;8:1039
pubmed: 28642751
World Neurosurg. 2019 Feb;122:e399-e407
pubmed: 30342265
Virulence. 2011 Sep-Oct;2(5):445-59
pubmed: 21921685
J Pharm Sci. 1990 May;79(5):428-31
pubmed: 2352163
J Pharm Pharmacol. 1994 Sep;46(9):718-24
pubmed: 7837040
J Orthop Res. 2007 Jul;25(7):858-66
pubmed: 17415753
Chem Soc Rev. 2006 Sep;35(9):780-9
pubmed: 16936926
Surg Neurol Int. 2016 Nov 09;7(Suppl 28):S746-S751
pubmed: 27904754
Adv Drug Deliv Rev. 2012 Sep;64(12):1090-110
pubmed: 22310160
J Orthop Trauma. 1995;9(5):401-6
pubmed: 8537843
Expert Rev Dermatol. 2010 Apr;5(2):183-195
pubmed: 20473345
J Neurosurg. 2016 Sep;125(3):766-70
pubmed: 26771856
J Orthop Trauma. 2003 Mar;17(3):212-6
pubmed: 12621263
Antimicrob Agents Chemother. 2003 Oct;47(10):3145-8
pubmed: 14506022
J Orthop Res. 2011 Jul;29(7):1070-4
pubmed: 21567453
J Craniofac Surg. 2017 Sep;28(6):1408-1412
pubmed: 28692506
Evid Based Complement Alternat Med. 2013;2013:801374
pubmed: 23662153
J Biochem. 1986 Dec;100(6):1575-82
pubmed: 3571189
Bone Joint J. 2016 Sep;98-B(9):1289-96
pubmed: 27587534
Scand J Trauma Resusc Emerg Med. 2015 Oct 06;23:75
pubmed: 26437934
World Neurosurg. 2017 Apr;100:305-310
pubmed: 28104524
J Biomater Appl. 2015 Nov;30(5):526-36
pubmed: 26163278
Semin Plast Surg. 2009 May;23(2):100-7
pubmed: 20567732
J Biomed Mater Res B Appl Biomater. 2010 Apr;93(1):51-8
pubmed: 20024966
Antimicrob Agents Chemother. 2006 Aug;50(8):2626-31
pubmed: 16870751
J Pharm Sci. 1997 May;86(5):565-72
pubmed: 9145380
Acta Neurochir (Wien). 2014 Apr;156(4):805-11; discussion 811
pubmed: 24493001
Acta Biomater. 2013 Dec;9(12):9558-67
pubmed: 23954526
Clin Microbiol Rev. 2014 Oct;27(4):870-926
pubmed: 25278577